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Covid-19 Update

Volume 809: debated on Thursday 4 February 2021


The following Statement was made in the House of Commons on Tuesday 2 February.

“I rise to make a Statement on the fightback against coronavirus.

Across the country, our vaccine roll-out continues at pace. With each vaccine we administer, we are one step closer to normal. As of today, we have vaccinated 9.2 million people. I thank everyone involved in this collective national effort that saw nearly 1 million people get vaccinated last weekend alone, or, to put it another way, one in 60 of all the adults in the UK. We have now protected almost nine out of every 10 people over 80 and half of people in their 70s. I am delighted that we have been able to visit every eligible care home, 10,307 in total. I want to thank everyone involved in that effort, including the NHS, our dedicated staff in social care, and the residents themselves, too, for coming forward. I pay tribute to the Minister for Care who has worked so hard to help us meet this ambitious target.

I know that many of us in this House are playing our part in the national vaccination effort. Today, we published a new resource for the House that provides more information on the vaccine roll-out and how all colleagues can play an important part in increasing the take-up of the vaccine in their area, because the take-up will directly impact how effective the vaccines are and how fast we can safely get out of this.

We are confident we have the supplies to meet our target to offer the vaccine to the four most vulnerable groups by 15 February. We now have over 400 million doses of vaccine on order, including the additional 40 million doses from Valneva that we ordered yesterday. That we find ourselves in this position is no accident. Our strategy has been to invest early and invest at risk. We have backed many horses, no matter where they are from, and we have also built up our vaccine manufacturing capability here at home.

As a result, today we have the AstraZeneca jab being manufactured in Oxford, Staffordshire and Wrexham, the Novavax vaccine made in Teesside and the Valneva vaccine manufactured in Livingston in Scotland. It is a great example of what we can achieve together, working as one United Kingdom.

Despite this optimistic backdrop, we must continue to act with caution, not least because of the renewed challenges posed by new variants of the coronavirus. We have found here 105 cases of the variant first identified in South Africa, including 11 cases that do not appear to have any links to international travel. As with the variant first identified here in the UK, there is currently no evidence to suggest it is any more severe, but we have to come down on it hard. Our mission must be to stop its spread altogether and break the chains of transmission.

In those areas where this variant has been found—parts of Broxbourne, London, Maidstone, Southport, Walsall and Woking—we are putting in extra testing and sequencing every positive test. Working with local authorities, we are going door to door to test everyone in those areas. Mobile testing units will be deployed, offering polymerase chain reaction tests to people who have to leave their home for work or other essential reasons. We have also seen 11 cases of mutations of concern in Bristol and 32 in Liverpool and are taking the same approach. In all these areas, it is imperative that people stay at home and only leave home when it is absolutely essential to do so.

When your local authority offers you a test, you should take up the offer, because we know that around one in three people with coronavirus has no symptoms but can still pass it on. We are offering testing to everyone aged 16 and over, even if they have been vaccinated. If you live in one of those areas, but have not been contacted and are unsure whether you should have a test, I encourage you to visit your local authority website to find out. Anyone who must leave home—to go to a workplace, for instance, because they cannot work from home—should get tested. All local employers should support and encourage their workers to get tested. The message is more important than ever: stay at home, maintain social distancing and get tested.

Across the whole country, we are expanding workplace testing, including here in Parliament. This morning, Mr Speaker, you and I together visited the new Covid testing site in Parliament which offers all those who work here—Peers, MPs and staff—the chance to get tested. I took a test this morning—it was, thankfully, negative. It is quick and easy and you get the result back fast. I encourage colleagues who have to be here in person to sign up and do the same.

For all of us, no matter where we live, we need to continue to follow the rules, because while more scientific work is under way to learn more about new variants, we know with absolute certainty that social distancing works. It denies the virus the social contact it needs to spread. We must all keep at it. We have sacrificed too much—and come so far with the vaccine—to give up now. I know that we will not.

While we have been working night and day to fight coronavirus, I have often drawn inspiration from our fight against another killer pandemic, HIV, a disease that also took too many people before their time. This is National HIV Testing Week. It is a reminder of how important it is to get your free HIV test, but it is also a reminder of the progress we have made in tackling that terrible pandemic that we can credibly commit to no new transmissions by the end of this decade. Today I am sure the whole House will join me in wishing Lord Norman Fowler a very happy 83rd birthday. He was an inspirational Health Secretary and a fearless advocate for tackling HIV and AIDS. Lord Fowler is someone who knows the importance of taking action early and the power of testing to turn the tide.

As we face these difficult weeks ahead, we can all draw inspiration from that great struggle and know that even when faced with a mountain of challenges, science, ingenuity and the sheer power of will can see us to better days ahead. I commend this Statement to the House.”

I thank the Minister for this debate on the Statement made in the Commons on Tuesday. I start by joining the Minister and everyone across Parliament and government in sadness at the death and in celebration of the life of Captain Sir Tom Moore. I also join everyone in celebrating the fact that 10 million people, 15% of the population, have now been vaccinated with a first dose. That is a fantastic achievement and I am so grateful to the NHS and all those who have contributed to this amazing national effort. Another Statement about vaccines is being taken in the Commons today, so I think we can see that this is a fast-moving world that requires Parliament to be quick on its feet to make an input and provide both scrutiny and support.

However, we are all aware of some people who are refusing the vaccine, including care workers. Can the Minister advise the House how many people in the priority vaccine groups have refused the vaccine? If he does not yet have these figures to hand, can he say when the figures, broken down by area, age, gender and ethnicity, will be available? This data seems to be crucial to understanding and tackling vaccine hesitancy moving forward. I am sure that the Minister will be aware of the research carried out by Professor Tim Spector and his team at King’s College London into why people are refusing or doubtful about the vaccine. Only yesterday there was a webinar about this. What was quite clear from that is that communication and example setting are important, and I hope that the Minister can share some of the thinking that may be going on about how to tackle this.

I turn now to the vaccination of the most vulnerable. I thank the Minister for his letter today in response to my question last week about how the bedridden and the homebound, and their carers, are being vaccinated. I would appreciate it if we could have some numbers showing how many people are in this vulnerable cohort. Only yesterday on the news we saw the example of an elderly man living alone who is recovering from cancer. He is isolated and his family are very anxious indeed that he has not yet been vaccinated.

According to recently released figures, Covid-19 deaths in care homes in the week ending 22 January represented 46% of all deaths in homes. That was the highest proportion of deaths since the beginning of the pandemic, surpassing even the previous high of 39.2% set last May. During that week, 1,817 care home deaths involved Covid-19, taking the total to more than 25,000. Gavin Terry, head of policy at the Alzheimer’s Society, said that, given the worsening figures

“staff vaccinations must be urgently prioritised along with rapid rollout of second jabs.”

The Government are being optimistic in saying that vaccines have been offered in care homes—but that is not the same as them having been taken up. Time is rolling on for older people who have not been able to see and touch their loved ones for almost a year. We all admit that this is cruel. In many ways, it underlines the dreadful inequalities that Covid has revealed in our society and its care of the most vulnerable.

If the current rate continues, the UK will be on track to have offered a dose to everyone in the top four priority groups by mid-February and to complete the remaining five priority groups in early April, when the need for the second dose begins.

The Minister will be aware of concerns as to whether medical and administrative staff can continue at the current pace for many months at a time, when many are already working seven days a week. What steps are the Government taking to relieve the pressure on staff and ensure that the pace of vaccination remains sustainable in the weeks and months ahead?

The new research from Oxford shows that the AstraZeneca vaccine is 76% effective after one dose and can reduce transmission by 67% over 12 weeks. This is fantastic news. Will the JCVI review this evidence and consider using the AZ vaccine to help prevent spread of the disease—not just serious illness and death—once everyone in the priority groups has received two doses? This would allow public health directors to speed up the vaccine rollout in more deprived communities, including among black and ethnic minority groups, and in hotspots where the disease is threatening to run out of control.

We all agree that children’s health must always be a priority. On current plans, how many teachers will be vaccinated as part of bands 5-9? How many teachers and support staff will have to wait until the period between Easter and summer to be vaccinated? Last September, it was reported that 25,000 teachers had been off sick with Covid-related illness, further disrupting children’s learning. How can the Government ensure that we do not see the same disruption again from March, when it is hoped that the schools will return? I hope that the JCVI will prioritise this as part of its review because, once schools have reopened, we need them to remain that way.

Finally, high infection rates, death rates and the identification of the South African variant in the community and the E484K mutation in the infectious Kent variant are deeply worrying. Although the noble Baroness, Lady Harding, claims that this was

“something that none of us were able to predict”,

the Minister must know that scientists have long warned of new variants as the pandemic unfolds and that the likelihood of mutations increases when there are high rates of transmission. It is more urgent than ever that this hole in our defences is fixed.

Increased testing is always welcome but will ultimately be insufficient unless test and trace is made to work for everyone. This week, the noble Baroness, Lady Harding, advised that at least 20% of people—she reckons approximately 20,000 a day—who should be self-isolating are not abiding by the rules. These figures demonstrate the need for both decent sick pay to break the chain of transmission and for test and trace to work properly.

My Lords, we also express our condolences to the family of Captain Sir Tom Moore. He was an inspiration and an example to so many.

The health Statement reminds us that this is HIV testing week. HIV Prevention England rightly says that the message about early HIV testing must be well publicised. I pay tribute to our Lord Speaker for his key role as Health Secretary in the 1980s in managing urgent and uncompromising messages to the public about HIV and AIDS. This Government could learn much from those campaigns about communicating clear messages.

From these Benches, we also echo the excellent news that 10 million people in the first four priority groups have been vaccinated so far. Last week, I asked the Minister whether the vaccine dashboard could break down vaccine take-up below national level. I note that this Statement says that this is happening at local health and local authority level. However, there is still no breakdown between health and social care staff. On Tuesday, the United Kingdom Homecare Association reported that only 32% of its staff had been vaccinated so far. It said that invitation to vaccinate care staff was a local lottery, with some areas having excellent arrangements, but others not. Live-in carers face even harder access to vaccines, as they are often completely left off local vaccination lists.

Further, we know that some care staff have concerns about taking the vaccine, so dialogue is vital. Recently, there was an excellent radio interview with a GP from the north-east who explained how they had talked to staff who were worried about vaccinations at the care home where they worked. Those staff were reassured and were vaccinated. Too many social care staff are just referred to large vaccination hubs with no opportunity to discuss it with a known and trusted GP. Will the Minister ensure that GP surgeries can still have vaccine doses for everyone in groups 1-4, including social care staff, so that the barriers to vaccination are tackled and removed? Please can we see the NHS and care staff separated out on the vaccine dashboard?

This Statement also raises the emerging problems with the South African variant, with further restrictions in some postcodes. These, as well as the new changes to the UK variant discovered in Bristol and Liverpool, remind us that Covid-19 is still challenging us at every turn. I say well done to the local directors of public health and leaders of councils, working with their local NHS, on their excellent speed of response and the clarity of their local messages to people in the relevant postcodes.

I have a couple of questions for the Minister. First, Ministers have said that the new South African variant problems were discussed and planned for last Thursday. So why was there not an announcement before the weekend, ensuring that affected residents could protect themselves and their neighbours as soon as the risk was apparent? Secondly, the Statement says that everyone in these areas must have a PCR test—good. However, a letter sent from the NHS to hospital staff said that no staff were to go to work until they had had the results of a PCR test. Given that hospitals already have a large number of staff off sick or self-isolating, what help are they getting to deal with further staff absences?

The Minister will remember that I have urged the Government to include unpaid carers in the priority list in order to protect those they care for. The announcement of their inclusion in priority group 6 is welcome. However, they are not in the summary lists in the vaccines delivery plan. Will the Minister commit to clear up any confusion by explicitly including unpaid carers in government communications and by publishing specific guidance on making sure that they are vaccinated as part of group 6?

Finally, we look forward to hearing the Prime Minister speak on 22 February about the route map out of this third lockdown. Progress on vaccination is vital, but test, trace and isolate is also essential if we are to avoid a fourth national lockdown. We on these Benches believe that people who are self-isolating should be paid their wages and have access to a proper care package, as in Germany and Taiwan. We have been asking for this for 11 months. The failure of people to comply with self-isolation rules demonstrates that the current system is not working. Will the Government urgently review the arrangements for isolation and encouragement to comply?

Yesterday, Chris Whitty and the Prime Minister were clear that this third lockdown cannot be lifted until it is safe to do so. Yet already MPs and some Peers are pressuring the PM to open schools immediately. Strong, clear messaging is needed every day—as strong as on the AIDS campaign by the noble Lord, Lord Fowler, 30 years ago. We know from polling data that the vast majority of people want to do the right thing. The Government’s role is to tell us what and why and to provide support for those who need help to do it.

My Lords, I am enormously grateful to both the noble Baronesses for their thoughtful and provocative questions. I join the noble Baroness, Lady Thornton, in paying tribute to Captain Sir Tom Moore. His story touched on something we have talked about in this Chamber this year: the way in which someone, in their 99th year, can make a tremendous impact on the whole country, bringing us together and raising money for NHS staff. It was an amazing achievement so late in life. It demonstrates that every year of every life, however late in that life it is, is valuable. That is why this Government are extremely proud of the measures that we have put in place to protect the lives of, and avoid severe harm to, the elderly and infirm.

I also share in the noble Baroness’s tribute to NHS staff and the vaccination rollout. She is entirely right; there is huge mental and social attrition across the NHS at the moment. The hard work that goes on, particularly in intensive care, is having a tough impact on those who work there. We hear of the need for some form of respite for NHS staff, loud and clear, but I have to be candid: when we are done dealing with the hospitalisations for Covid, there will be a massive wall of work to manage the huge backlog and restart business as usual. We are looking at the human investment needed. I pay tribute to my colleague Helen Whately, the Minister who covers the NHS workforce. She speaks to the NHS and social care workforce daily. We are looking extremely carefully at the investment that will be needed to support healthcare staff in the difficult year ahead.

The noble Baroness, Lady Thornton, asked about those who refuse the vaccine. I am afraid that those statistics do not exist, because people do not identify themselves as vaccine refusers. However, the overall picture is extremely positive at the moment. Those in categories 1 to 4 are stepping forward for the vaccine in tremendous numbers, and we are extremely encouraged by that. I take on board the insight of Tim Spector and others who have spoken thoughtfully about the barriers. I pay tribute to civic and particularly religious groups, which have often put vaccination sites in their temples, synagogues, churches and other religious settings. That is exactly the kind of trusted civic engagement that has led to vaccine deployment reaching deeply into communities that might otherwise have been worried or suspicious.

The challenge that we will face will be when we turn our attention to the younger. To answer the other question from the noble Baroness, Lady Thornton, we will be rolling out the vaccine to all age groups. The very good news from AstraZeneca about the vaccine being an extremely effective agent against transmissibility is exactly what we need to know, because it gives a green light to using the vaccine to avoid not just severe illness, hospitalisation and death, but transmissibility. We have to get the message across to those whose lives are not necessarily saved by the vaccine—it saves someone else’s life—that taking it is important and something they should feel trusting about and obligated to do. That will be the second phase of the vaccine rollout, and we are thinking carefully about how to do it as effectively as possible.

The noble Baroness, Lady Thornton, alluded to staff vaccination. She is entirely right about the very high number of Covid deaths in homes at the moment, and I reassure her that vaccines have been offered to every person in every home. There is an email address, which I would be happy to share with all noble Lords, for anyone who thinks that they have not been offered the vaccine. There is an absolute backstop for anyone who thinks that they have been overlooked or have missed out. We are doing our level best with an effective deployment and rollout programme to ensure that all social care homes, whatever their status, and all staff in them are protected by the vaccine.

I will say a word about schools and teachers. I completely support the views of the noble Baroness, Lady Thornton, and many other Peers who have spoken thoughtfully and emotionally about the importance of getting schools back. The Government and I agree that this is our priority. I spoke to the Schools Minister, Nick Gibb, about this yesterday. I pay tribute to the work of the Department for Education in rolling out testing in schools. Either today or very soon, we will have had the millionth test in schools, which is a great tribute to the work that schools, teachers and the DfE have done on asymptomatic testing in schools. It is an important way to cut the chain of transmission and to protect all those in schools, from both the disease and being agents of transmission to those who are more vulnerable. I support all the measures on social distancing, PPE and testing that we can put in place to keep schools open.

When it comes to vaccinating teachers, I emphasise that saving lives and avoiding severe harm is the priority for the vaccination programme. While we are sympathetic to teachers and will definitely have them on the prioritisation list, the protection from harm and death is our current priority.

We take the news on mutations from South Africa, Brazil, California, Kent and Bristol, and all the other manifestations of mutations, extremely seriously. The noble Baroness, Lady Harding, spoke about not expecting a mutation, but of course it was not the virus mutating that was not expected—that is commonplace. The CMO spoke about that impactfully and early, in February and March; he utterly predicted that mutations would lead to a second wave. But the virus had not mutated much last year. In fact, it was a phenomenally rigid and consistent virus for a long time. What was not easy to predict was that a highly transmissible disease would emerge that completely outperforms its previous classic manifestation. We saw that only when the infection rates started to climb extremely quickly. We changed our tack accordingly, and we continue to change our tack.

As I have said from the Dispatch Box previously, we are in a different game now. Previously, the focus was on keeping a lid on infection rates and getting the prevalence levels low. That remains an important feature of our battle against Covid. On the other hand, we have to protect the vaccine. We are aware of the potential for a mutation to emerge that escapes the vaccine. That has been seen in other diseases and could be seen in this disease. That is why we have mobilised Operation Eagle to track down the South African variants that have landed in the UK, where we do not have a clear chain of transmission. That is why we are going door to door, offering PCR testing to all those—around 10,000 people—in each of the relevant postcodes, to put a lid on any community transmission. That is why we have deployed a special team, tracing variants of concern, which is tracking down the origins of each infection to stamp out and suppress variants of concern, where they emerge.

This is exactly the kind of capability that we need to put in place should a highly transmissible vaccine-escaping variant manifest itself. I pay tribute to those in test and trace who have put together this capability extremely quickly and are implementing it so thoroughly.

Both the noble Baronesses, Lady Thornton and Lady Brinton, alluded to the important issue of isolating. I hear those points loud and clear. We support those who are isolating, and make a £500 payment to those on benefits, who need it. Charities and local authorities support those who isolate. But I hear the point made about additional measures, and we are looking at further ways to support those who are required to isolate, either because they are infected themselves or because they are the contact of someone who is infected.

The noble Baroness, Lady Brinton, spoke thoughtfully and movingly about the role of the Lord Speaker in fighting HIV and AIDS, and I join her in paying tribute to the Lord Speaker, whose 83rd birthday was earlier this week. The messaging in that campaign was poignant, it cut through and we all remember it very well.

I also pay tribute to those in the communications team who have, during the last year, put through some incredibly impactful campaigning around the Covid messages. There has been massive societal behavioural change because of the clarity and the impact of the campaigns that we have done. Those campaigns have got better and better, and the most recent “look into my eyes” campaign, as it is now called, is one of the most impactful. When we look back on this campaign, we will think very highly of the marketing and communication skills of those in the Department of Health, the Cabinet Office and other departments, who have worked so hard in this area.

The noble Baroness, Lady Brinton, alluded to the vaccination of social care staff. She is absolutely right to allude to lists. One of the current difficulties is that we do not have proper lists of all those who work in various roles in social care, either as domiciliary staff or in unpaid roles. My colleagues are looking at this, and we are moving quickly to address it. I know that the noble Baroness feels very strongly about the vaccine dashboard; I have taken it back to the department and spoken to the vaccine team about it and I will raise the matter with them again. Regarding the unpaid carers and the delivery plan, I will take that to the department again. I will be happy to write to the noble Baroness.

We now come to the 30 minutes allocated for Back-Bench questions. I ask that questions and answers be brief, so that I can call the maximum number of speakers.

My Lords, science has got us this far and will get us through in the long run. In that context, the recent report from the British Society for Immunology stresses the importance of knowing the efficacy of Covid-19 vaccines across all age groups and the need for immune monitoring across the vaccinated population. With the great news of over 10 million people having been vaccinated, we must know the nature and length of time of immunity that each vaccine delivers. The UK is in the best position to obtain this information that will help to plan future vaccination programmes, but we must start nationwide post-vaccination immune monitoring now. Will the Minister consider meeting the president of the society, Professor Arne Akbar, to explore this further?

My Lords, the noble Lord alludes with characteristic insight to one of the great frustrations and mysteries of Covid. It seems to me, a lay person and a neophyte in this area, that understanding the body’s immune response to something as simple as a virus such as Covid should be straightforward, but it is one of the unlocked mysteries of Covid. We are working extremely hard to unlock the mystery of it all. We have invested a huge amount in immunology and the detection of antibodies in the British public. I pay tribute to the UK Biobank study, a massive survey which has been going on for six months. It has found that 8.8% of the UK population had been infected by December 2020; 40% of them did not have a single classic symptom of Covid, and a quarter of those with antibodies were completely asymptomatic. We are doing other assessments as well—through the ONS, REACT, blood donors, the RCGP and others—and I would be very pleased to meet Professor Akbar to discuss this work further.

My Lords, in asking my noble friend the Minister about schools, I declare my interests as set out in the register. Last week, Public Health England confirmed that the health risks to and from the primary school population were very low, and that teachers are not at greater risk than the rest of the population of getting Covid or suffering its consequences. Other countries with similar case rates, such as the Netherlands, are planning to reopen their primary schools next week. Does the Minister agree that the toll of school closures is particularly acute on younger children and their parents, because those children often are unable to work independently, while the health benefits of these closures are minimal? Should the primary schools not be the very first institutions to open on 8 March?

My noble friend hits the nail on the head. Nothing could be a greater priority to the Government than the opening of all schools, and primary schools are at the top of the list. I pay tribute to all those parents and, if I may be so bold, particularly the mums, who have taken on the bulk of the work in dealing with young children at home while juggling other commitments to care and work. This is one aspect of one of the greatest emotional tolls on the British public. My noble friend is entirely right that the opening of schools is a massive priority. It hits hard those communities that depend on schools for care, and those that do not have the resources for at-home teaching. I completely agree with his assessment and assure him that it is a primary priority of the Government.

My Lords, the Minister also hits the nail on the head when he talks about a highly infectious new variant that is resistant to the vaccine. As he knows, the scientists have been pointing out that we will be living with this virus for a very long time, and other viruses like it will emerge in due course. I refer to an answer he gave me last week when I asked about antivirals. There are a number of antivirals in development at the moment in this country that look very promising, an interferon beta-based compound by Synairgen and ACTIV-2, which could be used for ambulant patients in the early stages of the disease. If we got people as soon as they had symptoms and tested positive, we could do a great deal of good and reduce the risk of mutation in the population. Have the Government any plans to do what they did excellently with vaccines: pre-order antivirals as they come through phase 3?

The noble Lord is entirely right to raise this issue. There is the awful possibility that the mutant vaccine escape virus could get around the vaccine altogether. We need a plan B, which might be dependent on antivirals as an alternative way of managing the disease. That is what happened with HIV, as we discussed last week. The therapeutic taskforce is looking at antivirals and putting together a plan to upscale our investment in that area. I am aware of Synairgen and ACTIV-2, but he is entirely right that this should now be a greater priority. I will take the matter back for the department to look into further.

My Lords, virologists tell us that, even with vaccines, we will be living with Covid for years to come. The Statement says:

“Our mission must be to stop its spread altogether and break those chains of transmission.”

To ensure that this happens, what changes have been made during this lockdown to improve the outcomes of the £22 billion test, trace and isolate system, for when the restrictions are eased?

My Lords, I pay immense tribute to the test and trace system, which, at 11 am, published remarkable performance figures, as the noble Lord probably knows; 92% of tests were turned around before the next day, and 86% of contacts were traced. This is an incredible performance. On his specific point, the creation of a variant-of-concern tracing group that is targeted at those rare appearances of VOCs in the community is the important development that we have put in place in reaction to the mutant variants. I pay tribute to Steve McManus, who is running that programme, for the impact that he has already made on the problem.

My Lords, with the emergence of new variants, questions over vaccine-induced antibody response to these and the risk of children as asymptomatic carriers, will the Government ensure that schools’ policies are flexible, adapted to each child’s needs, so that children shielding a very sick parent or sibling at home will be able to continue with home schooling and not be forced back through punitive threats on parents; while children needing the security of school can continue to access school as at present and when the majority have the benefit of being able to return?

I reassure the noble Baroness that we are absolutely putting the arrangements for pupils in the hands of schools themselves, because they know best how to look after their pupils and their teachers. The role of test and trace is to provide testing facilities and the resources to make schools safe, but it is up to the Department for Education, the local authorities and the schools themselves to protect those who need special arrangements, either because they are shielding or because they have other needs.

My Lords, I am sure that my noble friend will agree that everything possible must be done to ensure that this is the last national lockdown. To that end, is it not important that all information on vaccines, however sensitive it may be, is shared with Opposition leaders, if necessary, on Privy Council terms? Would it not help to avoid confrontations inside and outside the Chamber of the other place if the Prime Minister and the leader of the Opposition were to have a scheduled weekly meeting?

My Lords, they do have a scheduled weekly meeting: it is called PMQs. It is up to either side to decide how well it goes. To reassure my noble friend, we publish absolutely everything on the vaccine. We even publish the formula of the vaccine itself. The data is shared with local authorities—it is out there on the internet—and we could not be more transparent if we tried. We have worked very closely with the Information Commissioner; we have a massive data analytical team; and we are as open as we possibly can be because we believe that trust in the vaccine is absolutely essential to uptake, and therefore it is in our interests to take an open and transparent approach.

My Lords, the Minister said, quite rightly, that the priority for the vaccine is saving lives. Adults with learning difficulties have death rates comparable to those of the over-80s. Given the success of the vaccine rollout, is there any flexibility now for prioritising highly vulnerable groups, particularly when we know that the variants have to be controlled with extra vigilance?

My Lords, the noble Baroness is right, and I am grateful to her for giving me sight of her question in advance. Her point is completely valid and I support her interest in this. The JCVI has made it plain what the initial rollout of priority groups 1 to 4 will be, but there is a mechanism whereby it reviews and reassesses the rollout of further priority groups. That will be the moment when it can look at the kind of questions she raises about groups, such as those with learning difficulties, who have a high rate of mortality. I can reassure her that it is conducting a rolling review of the rollout of the vaccination and will take these matters into account.

My Lords, I ask the Minister about British citizens working overseas. I declare an interest in that my son is in this category. We have done such a fantastic job here on the vaccines to date, but there are many British citizens working abroad in a volunteer, business or diplomatic role. They recognise the need for quarantine and the need for vaccinations to enable them to work between their UK base and their overseas commitments. How best can the Government include those UK citizens in our vaccination programme—clearly, not giving them priority but to ensure that we protect their health, as well as that of people living in Britain at the moment?

My Lords, the Government take very seriously their commitments and obligations to those British citizens who live overseas. It is a matter of considerable concern that they be included in the vaccination deployment. However, there are certain practical challenges with this, so we invite those who want the vaccination to return to British shores so that they can be part of the vaccination process, and to ensure that they are registered with their GPs so that they are included in the list. The Prime Minister has made it very clear that we are putting border measures in place that will ensure that we are protected against mutations and variants. Once again, therefore, I invite all those living overseas who want the vaccination to ensure that they have thought-through arrangements in place to return to this country to get their vaccinations.

My Lords, there is evidence of hesitancy to take Covid-19 vaccinations, particularly among some minority communities. I am involved in a national campaign that is actively encouraging everyone to take the vaccine. I raised this point in your Lordships’ House on 13 January, and my noble friend Lord Callanan arranged for us to meet virtually with senior officials from the Vaccine Taskforce. We have had two productive meetings with officials and are moving forward in a satisfactory manner. We received support from Nadhim Zahawi’s office as well as support and participation from a number of other Members from both Houses. Kawsar Zaman, who is a young, bright barrister, is undertaking the bulk of the work on our side. I thank everyone who is rendering this support and assistance, including my noble friend Lord Bethell. I hope that if we all work together, we can achieve the right results in the country. Does my noble friend agree?

My Lords, I pay tribute to my noble friend for his work in this matter. I am extremely pleased to hear that the meetings with officials have gone well. I pay tribute to all those parliamentarians in this House and the other place for their spirit of collaboration and for the unity with which those with an ethnic background, in particular, have worked together to champion the message around the vaccine. It is only through example and trusted influencers that we can get our message across. It has been one of the really refreshing and uplifting moments of this awful disease to see the kind of cross-party collaboration that we have in this matter. I am extremely grateful to my noble friend and all his colleagues for the work they are doing in the community to get our message across.

My Lords, I am sure that the Minister will be aware that domiciliary care workers are very vulnerable. They toddle around from person to person, they visit people’s homes, and the people whom they support are also vulnerable. Will the Minister ensure that domiciliary care workers are given the maximum protection, whether through vaccines or through other protective measures?

Secondly—I could not give the Minister notice of this because I only got the details a few minutes before we started—refugees are being held at the Napier Barracks in Folkstone. I am told that there are people there with Covid who are sleeping in the same dormitories as refugees who do not have Covid. There is very little medical support. Will the Minister, as a matter of urgency, have a look at this and see what can be done?

My Lords, we have done an enormous amount for those who have been working in domiciliary care. The noble Lord is entirely right to shine a spotlight on those who play such an important role in the community, caring for the elderly and the infirm. The amount of itinerant travel, where these workers move from one person to another, has been dramatically reduced—partly to reduce the fear of infection. PPE has been used and we are putting testing in place for those working in domiciliary care. I am extremely pleased to report that this has had a huge impact on infection rates, and we will ensure that they are prioritised in the vaccine rollout accordingly.

I did not get the full details of the particular issue raised by the noble Lord in his second question, but if he would be kind enough to send me an email, I would be glad to look into it as he requested.

My Lords, further to the question from the noble Lord, Lord Winston, on antivirals, I raise the issue of monoclonal antibody production. The work of the Government in establishing an enduring manufacturing capability and rollout capacity for vaccines is deeply impressive. Why, then, do they appear to be stepping back from the push to rapidly manufacture antibodies, which was a core part of Kate Bingham’s Covid strategy?

My Lords, I am not sure whether we are completely stepping back from the production of monoclonal antibodies. I am extremely grateful to the noble Lord for the briefing that he shared with me last month and for the opportunities to look at how we can onshore the manufacturing of monoclonal antibodies. He is entirely right: this is a critical area of life science production where Great Britain is frustratingly massively behind. In the resilience of our healthcare supply chains, we have a huge gap in this country, and it is one that we are keen to address. The Therapeutics Taskforce is looking at monoclonal antibodies as a way of supporting our response to Covid and we have, through Project Defend, a workstream to look at how we can encourage onshore manufacturing of these essential healthcare supplies.

My Lords, recent laboratory tests by scientists at Cambridge University show that one dose of the Pfizer vaccine may not produce sufficient antibodies to kill off the virus, particularly for the over-80s, leaving them at risk of catching the South African variant. Will the Minister say what assessment the Government have made of these findings and what plans they have to speed up the second dose of the Pfizer vaccine for the over-80s and all care home residents?

My Lords, I am grateful for the reminder from the noble Baroness. The analysis we have done of the Pfizer vaccine, and indeed of all vaccines, is extremely encouraging and the impact it has on the body’s antibody production rate is profound. In fact, for many vaccines it might be that a longer delay, of 12 weeks, to the second dose might have an improved impact on the body. The second dose is really important for longevity rather than for efficacy, and therefore, with the data we have at the moment, we do not have any plans to change the pace of the rollout, but we are making sure in absolute terms that the second dose is delivered to all those who have had a first dose, promptly and on time.

My Lords, the Minister repeated the statement earlier that said that all care home residents and staff have been offered vaccination, but this is not true for homes for people with learning disabilities. I was pleased to hear in the Minister’s reply to the noble Baroness, Lady Andrews, that the JCVI is still considering priorities for groups 5 and 6. Is the Minister aware that 80% of the deaths of people with learning disabilities in England were Covid-19 related in the week ending 22 January, compared with 45% of the general population? Does he anticipate that all people with learning disabilities will be included in group 5 or 6?

My Lords, I have taken the noble Baroness’s insight on this to the department where it is being plugged into the Vaccine Taskforce and the JCVI. Her championship of this cause is to be lauded. The statistic she just cited is heart-rending, and I will definitely return to the department this afternoon and follow up, to ensure that it is being taken seriously.

My Lords, such has been the success of the vaccine rollout campaign that it seems that, by Easter, many millions of people will be due their second dose. Can my noble friend indicate how supplies will be allocated between them and the many millions of other people, often in public-facing jobs, who might still be awaiting their first?

My noble friend makes a key point on the dilemma we face. Do we prioritise the second dose or do we try to get the first dose to those who need it? Our policy is crystal clear: the second dose at 12 weeks will be delivered. Everyone who has had a first dose should get a letter or a contact in their 10th week and an appointment in the 11th week. That is our commitment, and we believe we have the supplies to see that through.

My Lords, I would like to pick up on the point made by my noble friend Lady Thornton about what is being done about refusal of the vaccine. I was rather alarmed by the Minister’s reply that there are no statistics on this. I accept that the Government have shown great transparency on vaccines, but the fact that there are no statistics on refusals is a worry. Do the Government think that more could be done by local authorities responsible for domiciliary care and care homes in their area to check on this? Could they be more active in trying to identify ethnic minorities on their lists who have not been vaccinated, so that something could be done?

I am afraid to say that the noble Lord’s point makes no sense to me whatever. We are not going to go around the country asking people whether they refused to take the vaccine. We have a dialogue with the whole country, and we wait patiently for people to step forward. I cannot give statistics on people who have refused because it would make no sense at all to ask people whether they are in that category.

My Lords, can the Minister tell the House what assessment the Government have made of the risks presented by aerosols, which, unlike droplets, are small enough to remain suspended in the air for hours and which expose individuals at distances beyond 2 metres? New evidence is emerging all the time, the latest just this week from the University of Bristol. Does he agree that we need a clearer position and stronger messaging on the risk of aerosol transmission indoors and the importance of ventilation, particularly as the vaccination programme rolls out, which will inevitably lead to calls to release restrictions and to reduce the 2-metre rule? We may need to add a fourth word, “ventilate”, to the mantra “hands, face, space”.

The noble Baroness is entirely right that understanding of the role of aerosols is growing. Frankly, I find it quite terrifying. She is right that we need to look particularly at the way our office spaces are ventilated. The statistics I have seen on the potential cost of rebooting the ventilation of the UK’s workspaces in order to make them Covid-friendly are that it would cost tens of billions of pounds. Our focus is therefore on vaccine deployment, but work is going on to reimagine and envisage how workspaces could be made safer, not just for this pandemic but for the future. I can imagine a world where ventilation is given greater hygienic priority in future.

My Lords, I was rather alarmed at my noble friend describing himself as a neophyte. He rather strikes me as being a battle-hardened veteran by this stage. I shall ask him about convalescent plasma. We had high hopes of it a year ago, yet the recovery trial at Nuffield College has now been ended and the BMJ has concluded that there is no convincing evidence of its effectiveness. And yet the NHS website is still seeking volunteers, and just this morning I heard a radio advertisement pleading for more volunteers to come forward. Will he clear up the apparent confusion there? Is it still a possibility that this might be something we are pursuing, or has it been put to one side?

My noble friend is right. The story of convalescent plasma is heartbreaking. I had extremely high hopes that it would be a rather wonderful way in which those who had been hit hard by Covid could be agents in the recovery of those who were newly in hospital. Convalescent plasma has a very successful record throughout history of being a source of therapeutic help, but the science is the science and we have to be respectful of the clinical trials, however heartbreaking the news is. We have massively downgraded our expectations. There is hope that convalescent plasma could be used in primary care in a very early intervention, but there are problems with the delivery of that medicine and primary care is not in great shape at the moment to be plugging blood into people just because they show some symptoms of Covid. We are continuing our collection until the last clinical trials in primary care are finalised, but I am afraid to say that our expectations in that area are much less than they were a few weeks ago.

My Lords, the Joint Committee on Human Rights has expressed concern about the lack of clarity in the rules for visiting care homes and the impact on the right to family life. Who must be vaccinated in a care home before relatives can visit? Is it all residents and all staff? If so, does that not seem unrealistic?

My Lords, I have huge sympathy with those looking at the human rights of those who cannot visit care homes. We have taken a huge hit to our civil liberties in our fight against this pandemic; no one can be under any illusion about that. However, I must say that the noble Baroness is wrong to hope that the vaccination gives any short-term hope that this will be changed. At the moment we are still living in a world where not enough people are vaccinated in order to stop the transmission through society, and where the rules on the transmissibility of the disease by those who are vaccinated have not been fully clarified. Therefore, even those who have been vaccinated should be staying at home.

My Lords, the Secretary of State rightly led his Statement with praise, mentioning the NHS and the many who have contributed to the successful jab results so far. However, he did not happen to mention the contribution made by members of the Armed Forces. Can the Minister say how many service men and women have been tasked with supporting this programme, and will the Treasury require the normal interdepartmental contribution to the defence budget to meet these military aid efforts?

My Lords, I do not have the precise figures that the noble Lord asks for at my fingertips. All I know is that the armed services have performed an enormously important role in the deployment of the vaccine. Their logistical expertise and hands-on implementation of the jabs themselves have been invaluable. But, without making too much of it, this really has been an NHS-led achievement. It has been the NHS at its best, and I pay tribute to those in social care and on the front line of the NHS who have led this remarkable deployment.

I regret that we have not been able to call everyone on the list but we have now come to the end of the 30 minutes allocated to Back-Bench questions. I shall give a few seconds for Members and Ministers to change around before we continue.